{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:13:11Z","timestamp":1787029991322,"version":"build-2736575974"},"reference-count":68,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"government of British Columbia"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Treatment as Prevention (TasP) and Pre-Exposure Prophylaxis (PrEP) are both widely recognized as essential biomedical tools to control HIV\/AIDS. TasP calls for the immediate initiation of fully subsidized and supported antiretroviral therapy (ART) following HIV diagnosis. TasP effectively prevents progression to AIDS, and premature AIDS-related deaths among people living with HIV (PLWH), and simultaneously renders HIV non-transmissible, thus preventing onward HIV transmission. In addition, PrEP has proven effective against HIV transmission among high-risk individuals who are adherent to the regimen. PrEP traditionally consists of two antiretrovirals given orally as one pill daily: originally, tenofovir-DF plus emtricitabine (TDF-FTC), and later, tenofovir-AF (TAF) plus FTC (more recently, other options have become available, including long-acting parenteral formulations; however, these are still of limited availability). Over the last two decades, the province of British Columbia has rolled out TasP among all PLWH, and starting in 2018, PrEP was added as a strategy to reach individuals most at risk of acquiring HIV to further accelerate progress in addressing HIV\/AIDS as a public health threat. Our \u201cgeneralized TasP + focused PrEP\u201d program proved to be synergistic (or multiplicative) as it relates to reducing the HIV effective reproduction number (Re). TasP lowers HIV incidence by reducing the pool of individuals able to transmit HIV, which is dependent on the extent of community plasma viral load (pVL) suppression. Meanwhile, PrEP reduces the number of potential new infections among those most susceptible to acquiring HIV in the community, independent of viral load suppression among PLWH. Our results strongly support widespread implementation of the combination of \u201cgeneralized TasP + focused PrEP\u201d strategy and underscore the importance of long-term monitoring of Re at a programmatic level to identify opportunities for optimizing TasP and PrEP programs. This approach aligns with the United Nations goal of \u201cEnding HIV\/AIDS as a pandemic by 2030\u201d, both in Canada and globally.<\/jats:p>","DOI":"10.3390\/tropicalmed10030075","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T04:55:44Z","timestamp":1741755344000},"page":"75","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Generalized Treatment as Prevention Plus Focused Pre-Exposure Prophylaxis Is the Key to Controlling HIV\/AIDS"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6201-9829","authenticated-orcid":false,"given":"Julio S. G.","family":"Montaner","sequence":"first","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS, Vancouver, BC V6Z 1Y6, Canada"},{"name":"Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4943-091X","authenticated-orcid":false,"given":"Viviane D.","family":"Lima","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS, Vancouver, BC V6Z 1Y6, Canada"},{"name":"Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate A.","family":"Salters","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS, Vancouver, BC V6Z 1Y6, Canada"},{"name":"Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junine","family":"Toy","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS, Vancouver, BC V6Z 1Y6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7013-1482","authenticated-orcid":false,"given":"Jeffrey B.","family":"Joy","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS, Vancouver, BC V6Z 1Y6, Canada"},{"name":"Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Guillemi","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS, Vancouver, BC V6Z 1Y6, Canada"},{"name":"Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3642-5986","authenticated-orcid":false,"given":"Rolando","family":"Barrios","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS, Vancouver, BC V6Z 1Y6, Canada"},{"name":"Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1001\/jama.1996.03540020068031","article-title":"Antiretroviral therapy for HIV infection in 1996. Recommendations of an international panel. International AIDS Society-USA","volume":"276","author":"Carpenter","year":"1996","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1001\/jama.2022.22246","article-title":"Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults: 2022 Recommendations of the International Antiviral Society-USA Panel","volume":"329","author":"Gandhi","year":"2023","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1097\/QAD.0b013e32802ef30c","article-title":"Continued improvement in survival among HIV-infected individuals with newer forms of highly active antiretroviral therapy","volume":"21","author":"Lima","year":"2007","journal-title":"AIDS"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/QAI.0000000000001014","article-title":"Narrowing the Gap in Life Expectancy Between HIV-Infected and HIV-Uninfected Individuals With Access to Care","volume":"73","author":"Marcus","year":"2016","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/S0140-6736(06)69162-9","article-title":"The case for expanding access to highly active antiretroviral therapy to curb the growth of the HIV epidemic","volume":"368","author":"Montaner","year":"2006","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/S0140-6736(08)61697-9","article-title":"Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: A mathematical model","volume":"373","author":"Granich","year":"2009","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Salomon, J.A., Hogan, D.R., Stover, J., Stanecki, K.A., Walker, N., Ghys, P.D., and Schwartl\u00e4nder, B. (2005). Integrating HIV prevention and treatment: From slogans to impact. PLoS Med., 2.","DOI":"10.1371\/journal.pmed.0020016"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1097\/01.aids.0000196566.40702.28","article-title":"Changes in sexual behavior and risk of HIV transmission after antiretroviral therapy and prevention interventions in rural Uganda","volume":"20","author":"Bunnell","year":"2006","journal-title":"AIDS"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1097\/00002030-200003100-00015","article-title":"Effect of highly active antiretroviral therapy on cervicovaginal HIV-1 RNA","volume":"14","author":"Caliendo","year":"2000","journal-title":"AIDS"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1097\/00002030-199710000-00008","article-title":"Effect of antiviral treatment on the shedding of HIV-1 in semen","volume":"11","author":"Vernazza","year":"1997","journal-title":"AIDS"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"12100","DOI":"10.1073\/pnas.92.26.12100","article-title":"Maternal plasma human immunodeficiency virus type 1 RNA level: A determinant and projected threshold for mother-to-child transmission","volume":"92","author":"Fang","year":"1995","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_12","first-page":"165","article-title":"Les personnes s\u00e9ropositives ne souffrant d\u2019aucune autre MST et suivant un traitement antir\u00e9troviral efficacene transmettent pas le VIH par voie sexuelle","volume":"89","author":"Vernazza","year":"2008","journal-title":"Bull. Med. Svizz."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"c2205","DOI":"10.1136\/bmj.c2205","article-title":"Combined antiretroviral treatment and heterosexual transmission of HIV-1: Cross sectional and prospective cohort study","volume":"340","author":"Castilla","year":"2010","journal-title":"BMJ"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2092","DOI":"10.1016\/S0140-6736(10)60705-2","article-title":"Heterosexual HIV-1 transmission after initiation of antiretroviral therapy: A prospective cohort analysis","volume":"375","author":"Donnell","year":"2010","journal-title":"Lancet"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2428","DOI":"10.1016\/S0140-6736(19)30418-0","article-title":"Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): Final results of a multicentre, prospective, observational study","volume":"393","author":"Rodger","year":"2019","journal-title":"Lancet"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1097\/QAI.0b013e3181e9b6b7","article-title":"HIV transmission risk among serodiscordant couples: A retrospective study of former plasma donors in Henan, China","volume":"55","author":"Wang","year":"2010","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1056\/NEJMoa1105243","article-title":"Prevention of HIV-1 infection with early antiretroviral therapy","volume":"365","author":"Cohen","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1056\/NEJMoa1600693","article-title":"Antiretroviral Therapy for the Prevention of HIV-1 Transmission","volume":"375","author":"Cohen","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/S0140-6736(23)00877-2","article-title":"The risk of sexual transmission of HIV in individuals with low-level HIV viraemia: A systematic review","volume":"402","author":"Broyles","year":"2023","journal-title":"Lancet"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/S0140-6736(23)01519-2","article-title":"HIV is sexually untransmittable when viral load is undetectable","volume":"402","author":"Bekker","year":"2023","journal-title":"Lancet"},{"key":"ref_21","unstructured":"Sidib\u00e9, M. (2023, September 13). AIDS at the Tipping Point: Herculean Challenges; Olympian Benefits. Available online: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/20100226_sp_sidibe_vancouver_en_0.pdf."},{"key":"ref_22","unstructured":"WHO\/UNAIDS (2023, September 13). The Treatment 2.0 Framework for Action: Catalyzing the Next Phase of Treatment, Care, and Support. Available online: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/20110824_JC2208_outlook_treatment2.0_en_0.pdf."},{"key":"ref_23","unstructured":"UNAIDS (2023, September 13). 90-90-90: Treatment for All. Available online: https:\/\/www.unaids.org\/en\/resources\/909090#:~:text=By%202020%2C%2090%25%20of%20all,therapy%20will%20have%20viral%20suppression."},{"key":"ref_24","unstructured":"UNAIDS (2023, September 13). 2025 AIDS TARGETS. Available online: https:\/\/www.unaids.org\/sites\/default\/files\/2025-AIDS-Targets_en.pdf."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Stover, J., Hallett, T.B., Wu, Z., Warren, M., Gopalappa, C., Pretorius, C., Ghys, P.D., Montaner, J., Schwartl\u00e4nder, B., and The New Prevention Technology Study Group (2014). How can we get close to zero? The potential contribution of biomedical prevention and the investment framework towards an effective response to HIV. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0111956"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2587","DOI":"10.1056\/NEJMoa1011205","article-title":"Preexposure chemoprophylaxis for HIV prevention in men who have sex with men","volume":"363","author":"Grant","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"151ra125","DOI":"10.1126\/scitranslmed.3004006","article-title":"Emtricitabine-tenofovir concentrations and pre-exposure prophylaxis efficacy in men who have sex with men","volume":"4","author":"Anderson","year":"2012","journal-title":"Sci. Transl. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2237","DOI":"10.1056\/NEJMoa1506273","article-title":"On-Demand Preexposure Prophylaxis in Men at High Risk for HIV-1 Infection","volume":"373","author":"Molina","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e402","DOI":"10.1016\/S2352-3018(17)30089-9","article-title":"Efficacy, safety, and effect on sexual behaviour of on-demand pre-exposure prophylaxis for HIV in men who have sex with men: An observational cohort study","volume":"4","author":"Molina","year":"2017","journal-title":"Lancet HIV"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1056\/NEJMoa1402269","article-title":"VOICE Study Team. Tenofovir-based preexposure prophylaxis for HIV infection among African women","volume":"372","author":"Marrazzo","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_31","unstructured":"British Columbia Centre for Excellence in HIV\/AIDS (2025, January 14). Guidance for the Use of Pre-Exposure Prophylaxis (PrEP) for the Prevention of HIV Acquisition in British Columbia. Available online: https:\/\/bccfe.ca\/wp-content\/uploads\/2023\/12\/prep_guidelines_17-jun-2020.pdf."},{"key":"ref_32","unstructured":"WHO (2023, September 13). Guideline on When to Start Antiretroviral Therapy and on Pre-Exposure Prophylaxis for HIV. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789241509565."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1001\/jama.2016.8900","article-title":"Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults: 2016 Recommendations of the International Antiviral Society-USA Panel","volume":"316","author":"Gunthard","year":"2016","journal-title":"JAMA"},{"key":"ref_34","unstructured":"Centers for Disease Control and Prevention (2023, September 13). Recommendations for HIV Prevention with Adults and Adolescents with HIV in the United States, Available online: https:\/\/stacks.cdc.gov\/view\/cdc\/44064."},{"key":"ref_35","unstructured":"European AIDS Clinical Society (EACS) (2023, September 13). European AIDS Clinical Society Guidelines Version 8.0. Available online: https:\/\/www.eacsociety.org\/media\/guidelines_8_0-english_web.pdf."},{"key":"ref_36","unstructured":"United Nations (2023, September 13). The 17 Goals | Sustainable Development. Available online: https:\/\/sdgs.un.org\/goals."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e397","DOI":"10.1016\/S2352-3018(21)00071-0","article-title":"Long-term safety and efficacy of emtricitabine and tenofovir alafenamide vs. emtricitabine and tenofovir disoproxil fumarate for HIV-1 pre-exposure prophylaxis: Week 96 results from a randomised, double-blind, placebo-controlled, phase 3 trial","volume":"8","author":"Ogbuagu","year":"2021","journal-title":"Lancet HIV"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1056\/NEJMoa2407001","article-title":"Twice-yearly lenacapavir or daily F\/TAF for HIV prevention in cisgender women","volume":"391","author":"Bekker","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Kelley, C.F., Acevedo-Qui\u00f1ones, M., Agwu, A.L., Avihingsanon, A., Benson, P., Blumenthal, J., Brinson, C., Brites, C., Cahn, P., and Cantos, V.D. (2024). Twice-yearly lenacapavir for HIV prevention in men and gnder-diverse persons. N. Eng. J. Med., Online ahead of print.","DOI":"10.1056\/NEJMoa2411858"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e567","DOI":"10.1016\/S2352-3018(24)00217-0","article-title":"A game-changer for PrEP if access is adequate (Editorial)","volume":"11","author":"Hiv","year":"2024","journal-title":"Lancet HIV"},{"key":"ref_41","unstructured":"British Columbia Centre for Excellence in HIV\/AIDS (BC-CfE) (2024, December 10). Therapeutic Guidelines for Antiretroviral (ARV) Treatment of Adult HIV Infection. BC-CfE. Available online: https:\/\/bccfe.ca\/bccfe-documents\/therapeutic-guidelines-for-antiretroviral-arv-treatment-of-adult-hiv-infection\/."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"21941","DOI":"10.7448\/IAS.20.1.21941","article-title":"A historical review of HIV prevention and care initiatives in British Columbia, Canada: 1996\u20132015","volume":"20","author":"Olding","year":"2017","journal-title":"J. Int. AIDS Soc."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s11904-020-00482-6","article-title":"The Impact of Treatment as Prevention on the HIV Epidemic in British Columbia, Canada","volume":"17","author":"Lima","year":"2020","journal-title":"Curr. HIV\/AIDS Rep."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Munasinghe, L.L., Toy, J., Lepik, K.J., Moore, D.M., Hull, M., Bacani, N., Sereda, P., Barrios, R., Montaner, J.S.G., and Lima, V.D. (2023). Process description of developing HIV prevention monitoring indicators for a province-wide pre-exposure prophylaxis (PrEP) program in British Columbia, Canada. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0283025"},{"key":"ref_45","unstructured":"(2025, February 25). BCCDC Non-certified Practice Decision Support Tool: HIV Pre Exposure Prophylaxis (HIV PrEP). Available online: http:\/\/www.bccdc.ca\/resource-gallery\/Documents\/Communicable-Disease-Manual\/Chapter%205%20-%20STI\/PrEP-DST.pdf."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Biggerstaff, M., Cauchemez, S., Reed, C., Gambhir, M., and Finelli, L. (2014). Estimates of the reproduction number for seasonal, pandemic, and zoonotic influenza: A systematic review of the literature. BMC Infect. Dis., 14.","DOI":"10.1186\/1471-2334-14-480"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Kim, D., Ali, S.T., Kim, S., Jo, J., Lim, J.-S., Lee, S., and Ryu, S. (2022). Estimation of Serial Interval and Reproduction Number to Quantify the Transmissibility of SARS-CoV-2 Omicron Variant in South Korea. Viruses, 14.","DOI":"10.3390\/v14030533"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1038\/326137a0","article-title":"Transmission dynamics of HIV infection","volume":"326","author":"May","year":"1987","journal-title":"Nature"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1098\/rstb.1988.0108","article-title":"The transmission dynamics of human immunodeficiency virus (HIV)","volume":"321","author":"May","year":"1988","journal-title":"Philos. Trans. R. Soc. Lond. B Biol. Sci."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3201\/eid2501.171901","article-title":"Complexity of the Basic Reproduction Number (R(0))","volume":"25","author":"Delamater","year":"2019","journal-title":"Emerg. Infect. Dis."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1017\/S0950268804002997","article-title":"Definition and estimation of an actual reproduction number describing past infectious disease transmission: Application to HIV epidemics among homosexual men in Denmark, Norway and Sweden","volume":"132","author":"Amundsen","year":"2004","journal-title":"Epidemiol. Infect."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1097\/PHH.0000000000001397","article-title":"Estimating the HIV Effective Reproduction Number in the United States and Evaluating HIV Elimination Strategies","volume":"28","author":"Chen","year":"2022","journal-title":"J. Public Health Manag. Pract."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Lima, V.D., Rozada, I., Grebely, J., Hull, M., Lourenco, L., Nosyk, B., Krajden, M., Yoshida, E., Wood, E., and Montaner, J.S.G. (2015). Are Interferon-Free Direct-Acting Antivirals for the Treatment of HCV Enough to Control the Epidemic among People Who Inject Drugs?. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0143836"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2186","DOI":"10.1001\/jama.2020.7878","article-title":"Public Health Measures and the Reproduction Number of SARS-CoV-2","volume":"323","author":"Inglesby","year":"2020","journal-title":"JAMA"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e461","DOI":"10.1016\/S2352-3018(24)00094-8","article-title":"Longitudinal evolution of the HIV effective reproduction number following sequential expansion of treatment as prevention and pre-exposure prophylaxis in British Columbia, Canada: A population-level programme evaluation","volume":"11","author":"Lima","year":"2024","journal-title":"Lancet HIV"},{"key":"ref_56","unstructured":"British Columbia Centre for Excellence in HIV\/AIDS (BC-CfE) (2023, June 26). Drug Treatment Program. Available online: https:\/\/www.bccfe.ca\/drug-treatment-program#:~:text=The%20Drug%20Treatment%20Program%20."},{"key":"ref_57","unstructured":"(2023, July 26). Public Health Agency of Canada. Estimates of HIV Incidence, Prevalence and Canada\u2019s Progress on Meeting the 90-90-90 HIV Targets, Available online: https:\/\/www.canada.ca\/en\/public-health\/services\/publications\/diseases-conditions\/estimates-hiv-incidence-prevalence-canada-meeting-90-90-90-targets-2020.html#a4.3."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"103195","DOI":"10.1016\/j.drugpo.2021.103195","article-title":"Overdose mortality is reducing the gains in life expectancy of antiretroviral-treated people living with HIV in British Columbia, Canada","volume":"96","author":"Dong","year":"2021","journal-title":"Int. J. Drug Policy"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1097\/QAD.0b013e32833af85d","article-title":"Expanding access to HAART: A cost effective approach for treating and preventing HIV","volume":"24","author":"Johnston","year":"2010","journal-title":"AIDS"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Granich, R., Kahn, J.G., Bennett, R., Holmes, C.B., Garg, N., Serenata, C., Sabin, M.L., Makhlouf-Obermeyer, C., Mack, C.D.F., and Williams, P. (2012). Expanding ART for Treatment and Prevention of HIV in South Africa: Estimated Cost and Cost-Effectiveness 2011\u20132050. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0030216"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1056\/NEJMsa1214720","article-title":"Cost-Effectiveness of HIV Treatment as Prevention in Serodiscordant Couples","volume":"369","author":"Walensky","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/S2352-3018(15)00127-7","article-title":"Cost-effectiveness of population-level expansion of highly active antiretroviral treatment for HIV in British Columbia, Canada: A modelling study","volume":"2","author":"Nosyk","year":"2015","journal-title":"Lancet HIV"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Gomez, G.B., Borquez, A., Case, K.K., Wheelock, A., Vassall, A., and Hankins, C. (2013). The Cost and Impact of Scaling Up Pre-exposure Prophylaxis for HIV Prevention: A Systematic Review of Cost-Effectiveness Modelling Studies. PLoS Med., 10.","DOI":"10.1371\/journal.pmed.1001401"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1016\/S1473-3099(14)70025-8","article-title":"HIV pre-exposure prophylaxis in men who have sex with men and transgender women: A secondary analysis of a phase 3 randomised controlled efficacy trial","volume":"14","author":"Buchbinder","year":"2014","journal-title":"Lancet Infect. Dis."},{"key":"ref_65","unstructured":"(2025, January 14). HIV in Canada: 2023 Surveillance Highlights. Available online: https:\/\/www.canada.ca\/en\/public-health\/services\/publications\/diseases-conditions\/hiv-2023-surveillance-highlights-infographic.html."},{"key":"ref_66","unstructured":"(2025, January 14). The Urgency is Now, AIDS at a Crossroads; 2024 Global AIDS Update. Available online: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/2024-unaids-global-aids-update_en.pdf."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1111\/add.12999","article-title":"Design and baseline findings of a large-scale rapid response to an HIV outbreak in people who inject drugs in Athens, Greece: The ARISTOTLE programme","volume":"110","author":"Hatzakis","year":"2015","journal-title":"Addiction"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1080\/09540121.2019.1601671","article-title":"Identifying, linking, and treating people who inject drugs and were recently infected with HIV in the context of the network-based intervention","volume":"31","author":"Psichogiou","year":"2019","journal-title":"AIDS Care"}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/10\/3\/75\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:51:05Z","timestamp":1760028665000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/10\/3\/75"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,12]]},"references-count":68,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["tropicalmed10030075"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed10030075","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,12]]}}}